Articles: nerve-block.
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Randomized Controlled Trial Comparative Study Clinical Trial
The sciatic nerve block in emergency settings: a comparison between a new anterior and the classic lateral approaches.
Anterior and lateral approaches to the sciatic nerve block are performed with the patient in the supine position. This could be an important advantage when mobilization to the limb involved is limited or painful, particularly in emergency conditions. The aim of this prospective, randomized study was to compare these two sciatic nerve blockades performed in an emergency setting. ⋯ These data suggest that both techniques are of similar value in an emergency setting.
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Anesthesia and analgesia · Oct 2004
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of single versus multiple injections on the extent of anesthesia with coracoid infraclavicular brachial plexus block.
Single-injection coracoid infraclavicular brachial plexus block produces inconsistent anesthesia of the upper limb. In this study, we sought to determine the number of injections needed to provide a reasonably complete anesthesia of the upper limb with this approach. Seventy-five patients were randomly assigned to receive a coracoid block guided by nerve stimulator with 42 mL of 1.5% mepivacaine with a single-injection (Group 1), dual-injection (Group 2), or triple-injection (Group 3) technique. ⋯ Significantly less complete paralysis for arm, wrist, and hand movements was found in Group 1 at 20 min. No significant difference was found between Groups 2 and 3. We conclude that dual and triple injection of local anesthetic guided by nerve stimulator increases the efficacy of coracoid block when compared with a single-injection technique.
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Anesthesia and analgesia · Oct 2004
Randomized Controlled Trial Comparative Study Clinical TrialAnalgesia before performing a spinal block in the sitting position in patients with femoral shaft fracture: a comparison between femoral nerve block and intravenous fentanyl.
We conducted this prospective, randomized study to compare the analgesic effect of femoral nerve block and IV fentanyl administration when given to facilitate the sitting position for spinal anesthesia in patients undergoing surgery for femoral shaft fracture. Five minutes before the placement of spinal block, group FEM patients (n = 10) received a femoral nerve block with lidocaine 1.5% 15 mL, and group IVA patients (n = 10) received IV fentanyl 3 microg/kg. Visual analog scale values during positioning (median and range) were lower in group FEM: 0.5 (0-1) versus 3 (2-6) (P < 0.001). ⋯ Patient acceptance was less in group IVA (P < 0.05). In one group IVA patient, an oxygen saturation <90% was recorded during the procedure. We conclude that femoral nerve block is more advantageous than IV administration of fentanyl to facilitate the sitting position for spinal anesthesia in patients undergoing surgery for femoral shaft fractures.
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Comparative Study
Cervical nerve root blocks: indications and role of MR imaging.
To examine whether magnetic resonance (MR) imaging findings of the cervical spine can predict pain relief after selective computed tomography (CT)-guided nerve root block and thus assist in the appropriate selection of patients who are suitable for this procedure. ⋯ MR imaging of the cervical spine assists in the appropriate selection of patients suitable for CNRB. Patients with foraminal disk herniation, foraminal nerve root compromise, and no spinal canal stenosis appear to have the greatest pain relief after this procedure.
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Regional anesthesia can be the technique of choice for selected ambulatory surgery procedures, but in spite of its benefits, it has an inherent failure rate even in experienced hands. We examine the efficacy and factors associated with failure of ambulatory regional anesthesia techniques. ⋯ High BMI and ASA IV are independent risk factors for block failure in ambulatory surgery patients.